High and Equitable Coverage of Vitamin A Supplementation Program in Nepal

Background: This paper examines the coverage and equity aspects of the vitamin A supplementation program in Nepal program followed by a review of factors that led to the gains over time. Data and methods: Data from the 1996 and 2001 Nepal Demographic and Health Surveys are used. Variations in coverage by child’s age, sex, mother’s education, residence, and ecological-development sub-regions are analyzed by using descriptive and multivariate logistic regression techniques. Findings: The percentage of children ages 6-35 months dosed with the supplementation was 32% in 1996; that increased to 78% by 2001. The differences in coverage rates for various subgroups were relatively small by 2001. The most important factors contributing to the achievement were a systematic and incremental approach to scale-up, the role played by Female Community Health Volunteers, an effective public-private partnership, and sustained donor support. Conclusion: The vitamin A program’s success offer valuable lessons for Nepal and elsewhere.